Presentation

Patient Data

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Oblique

Left foot.

The tarsal bones show normal density with loss of cartilage and subchondral cysts/erosions at the lesser tarsometatarsal and some of the intertarsal articulations. Bone fragments and osteophytes are best seen dorsally on the lateral projection.

Site of abnormality and the appearance in a patient with long standing diabetes is consistent with a diabetic neuroarthropathy (Charcot).

Appearance is that of a Charcot arthropathy of the mid foot. There are no features to suggest infection.

Case Discussion

Articular abnormality at this site in a diabetic patient is most likely due to a neuropathic arthropathy rather than infection. With a rocker bottom foot she is at risk of infection but there is no sinus tract to the plantar surface of the foot that is likely to occur as a precurser to infection.